Medical mistakes are made. But when it comes to compensating the victim, legal and insurance routes often set up their own obstacles.

What many patients don't recognize is that bad outcomes aren't always the result of bad medicine. Nothing goes perfectly 100% of the time in medical care. The vast majority of people who undergo general anesthesia tolerate it well, but a small percentage experience a life-threatening reaction even if the drugs are administered properly. Colonoscopy is generally a very safe procedure, but serious complications — such as bowel perforations and bleeding — sometimes occur unexpectedly. And so on.

Doctors need to be more open, for sure. But patients need to acknowledge the risks inherent in their care and accept that things may not always turn out as well as they'd hope. They need to realize that when things go wrong, there's not always someone to blame.

It's often not easy for patients to differentiate bad luck from bad care, of course. And on many levels, the liability system makes distinguishing the two more difficult. It puts doctors on the defensive and undermines patients' trust, closing down communication at a time when the best medicine would be dialogue.

Ulene is a board-certified specialist in preventive medicine practicing in Los Angeles. The M.D. appears once a month.